Risk Factor

Alterations and Effect on Risk Factor


carbohydrates may increase the risks of root as well as crown caries in remaining teeth. Chronic alcohol abuse, especially among heavy smokers, increases the risks of oral and head and neck cancers.

Decreased risk: Diets low in sticky, fermentable carbohydrates decrease the risk of root and crown caries, as does good oral hygiene. Diets containing adequate intakes of nutrients minimize risks to oral tissues as a result of dietary deficiency disease.


Increased risk: Inadequate intakes of calcium and vitamin D, especially early in life during the time of accretion of peak bone mass as well as in the premenopausal period, increase risks of osteoporosis, especially if estrogen replacement therapy is absent. Caffeine intake may also increase osteoporosis risks, as may highly acid diets. Malnutrition secondary to untreated gastrointestinal disease increases risks because absorption of calcium and vitamin D may be affected, especially if steatorrhea is present. Sedentary lifestyles with little physical activity increase risk, especially if there is little physical exercise involving weight bearing. Alcohol abuse or its consumption in large amounts may increase risks.

Decreased risk: Adequate intakes of calcium throughout life with estrogen replacement therapy after menopause and exercise involving weight bearing decrease risks.


Increased risk: Smoking plus chronic alcohol intake increases head and neck cancer risks. Low intakes of caratenoids and of other, as yet poorly characterized constituents of vegetables and fruits may increase smoking-related cancer risks.

Decreased risk: Possible slight (but relatively insignificant) decrease could be achieved for certain forms of cancer from intakes of vegetables and fruits that are high in ascorbic acid, carotenoids, and other vitamin A precursors.

Social isolation, low socioeconomic status, and false stereotypes of aging

Increased risk: Undernutrition, emaciation, insufficiencies of vitamins and minerals, and excessive intakes of fat, salt, sugar, and energy are often associated with these in low-income groups. In fact, these nutritional problems may be due in part to lack of income. Those suffering from any form of malnutrition have increased risk of being socially isolated, and the process is likely to be self-perpetuating. Alcohol abuse may be especially important in causing social isolation. Malnutrition reinforces the stereotype that being old is being sick.

Decreased risk: Good nutrition in all respects minimizes the above barriers.

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